ENDOVASCULAR TREATMENT OF CEREBRAL ANEURYSMS FOLLOWING INCOMPLETE CLIPPING

The authors report their experience using electrolytically detachable coils for the treatment of residual cerebral aneurysms following incom plete surgical clipping. Eight patients were treated for six anterior and two posterior circulation aneurysm remnants. All patients were ref erred for endovascular treatment by experienced cerebrovascular neuros urgeons at the authors' institution. Patients underwent follow-up angi o graphy immediately after endovascular treatment. In seven of the eig ht patients, additional follow-up angiographic studies were obtained a t periods ranging from 7 weeks to 2 years posttreatment. The latest fo llow-up angiograms demonstrated that six of the eight aneurysm remnant s were 100% occluded, with near-complete occlusion of the other two an eurysm remnants. There was no permanent neurological or non-neurologic al morbidity or mortality associated with the treatment. There was no incidence of aneurysm hemorrhage during or after treatment. Endovascul ar treatment of cerebral aneurysm remnants following prior surgical cl ipping can be accomplished with acceptable morbidity and mortality rat es. Endovascular coil occlusion can play an important adjunctive role in the treatment of those aneurysms that have been incompletely oblite rated by surgical clipping.